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. 2023 Jun;39(3):529-534.
doi: 10.1111/jrh.12729. Epub 2022 Nov 28.

Is being there enough? Postgraduate nurse practitioner residencies in rural primary care

Louise Kaplan  1 , Samantha W Pollack  2   3 , Susan M Skillman  2   3 , Davis G Patterson  2   3
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Is being there enough? Postgraduate nurse practitioner residencies in rural primary care

Louise Kaplan et al. J Rural Health. 2023 Jun.

Abstract

Purpose: Little research has been conducted on the outcomes of postgraduate nurse practitioner (NP) programs (referred to as residencies), particularly those located in rural communities. This study examined the purpose and characteristics of rural NP residencies that aim to promote the successful recruitment, transition, and retention of NPs in rural primary care practice.

Methods: We compiled a list of rural NP residencies and verified the location of each clinic as rural if it met any of several federal definitions of rurality. We interviewed grant and project administrators, residency program directors, clinic personnel, and former and current NP residents using semistructured guides.

Findings: Of 20 rural NP residencies identified, we interviewed 12 program directors or managers; 8 NPs; and 4 clinic personnel. All but 1 program was 12 months long. Three-quarters had federal funding. Each slowly increased residents' patient load and included didactic content and specialty rotations. We identified 2 different program models and 3 administrative models. Some NPs' intentionally chose rural practice, while others opted for a rural residency when unable to secure employment in an urban location. Most programs were new and not yet able to report on residents' subsequent employment locations.

Conclusions: It is premature to conclude definitively that rural NP residencies facilitate and promote NP connectedness to, and investment in, rural communities based on our investigation. Nonetheless, these programs are an option to encourage the recruitment and retention of NPs in rural practice, with further study needed to determine their long-term contribution to rural primary care practice.

Keywords: nurse practitioner postgraduate residencies; nurse practitioners; primary care; rural communities; rural practice.

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References

REFERENCES

    1. US Department of Health and Human Services. Health Workforce Strategic Plan. Health Resources and Services; 2021.
    1. Kaplan L, Pollack S, Skillman SM, Patterson DG. Factors that encourage and support advanced practice registered nurses to work in rural and safety-net settings. J Health Care Poor Underserved. 2020;31(5):163-181.
    1. Barnes H, Richards MR, McHugh MD, et al. Rural and nonrural primary care physician practices increasingly rely on nurse practitioners. Health Aff. 2018;37(6):908-914.
    1. Kaplan L, Skillman S, Pollack S, Patterson D. The readiness of NP students for transition to rural practice. Nurse Pract. 2020;45(10):48-55.
    1. Kippenbrock T, Stacy A, Gilbert-Palmer D. Educational strategies to enhance placement and retention of nurse practitioners in rural Arkansas. J Am Acad Nurse Pract. 2004;16(3):139-143.

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